A mixed methods analysis of existing assessment and evaluation tools (AETs) for mental health applications

Sarah Ahmed; Chris Trimmer; Wishah Khan; Andrew Tuck; Terri Rodak; Branka Agic; Kelsey Kavic; Sapna Wadhawan; Maureen Abbott; M Omair Husain; M Ishrat Husain; Kwame McKenzie; Yuri Quintana; Farooq Naeem

doi:10.3389/fpubh.2024.1196491

A mixed methods analysis of existing assessment and evaluation tools (AETs) for mental health applications

Front Public Health. 2024 May 7:12:1196491. doi: 10.3389/fpubh.2024.1196491. eCollection 2024.

Authors

Sarah Ahmed¹, Chris Trimmer¹, Wishah Khan¹, Andrew Tuck¹, Terri Rodak¹, Branka Agic^{1

2}, Kelsey Kavic³, Sapna Wadhawan³, Maureen Abbott³, M Omair Husain^{1

2}, M Ishrat Husain^{1

2}, Kwame McKenzie^{1

2}, Yuri Quintana^{4

5}, Farooq Naeem^{1

2}

Affiliations

¹ Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
² Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
³ Mental Health Commission of Canada, Ottawa, ON, Canada.
⁴ Harvard Medical School, Harvard University, Boston, MA, United States.
⁵ Division of Clinical Informatics, Beth Israel Deaconess Medical Center, Boston, MA, United States.

Abstract

Introduction: Mental health Applications (MH Apps) can potentially improve access to high-quality mental health care. However, the recent rapid expansion of MH Apps has created growing concern regarding their safety and effectiveness, leading to the development of AETs (Assessment and Evaluation Tools) to help guide users. This article provides a critical, mixed methods analysis of existing AETs for MH Apps by reviewing the criteria used to evaluate MH Apps and assessing their effectiveness as evaluation tools.

Methods: To identify relevant AETs, gray and scholarly literature were located through stakeholder consultation, Internet searching via Google and a literature search of bibliographic databases Medline, APA PsycInfo, and LISTA. Materials in English that provided a tool or method to evaluate MH Apps and were published from January 1, 2000, to January 26, 2021 were considered for inclusion.

Results: Thirteen relevant AETs targeted for MH Apps met the inclusion criteria. The qualitative analysis of AETs and their evaluation criteria revealed that despite purporting to focus on MH Apps, the included AETs did not contain criteria that made them more specific to MH Apps than general health applications. There appeared to be very little agreed-upon terminology in this field, and the focus of selection criteria in AETs is often IT-related, with a lesser focus on clinical issues, equity, and scientific evidence. The quality of AETs was quantitatively assessed using the AGREE II, a standardized tool for evaluating assessment guidelines. Three out of 13 AETs were deemed 'recommended' using the AGREE II.

Discussion: There is a need for further improvements to existing AETs. To realize the full potential of MH Apps and reduce stakeholders' concerns, AETs must be developed within the current laws and governmental health policies, be specific to mental health, be feasible to implement and be supported by rigorous research methodology, medical education, and public awareness.

Keywords: digital health; evaluation; guidelines; mental health; mobile apps.

MeSH terms

Humans
Mental Health
Mental Health Services / standards
Mobile Applications* / standards

Grants and funding

Funding for this work was provided by the Mental Health Commission of Canada initiative − Environmental scan and literature review of existing assessment tools and related initiatives for mental health apps. Authors FN, AT, BA, KM received this grant. The study funders supported the study design and preparation of the manuscript.